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Vaginismus is a condition that does not allow a woman to have normal vaginal intercourse. In its mildest form, a woman can get a penis into the vagina for very short periods, but it's unpleasant and painful. Or it can be so severe that she can't even touch herself near her vagina, can't have a gynecological exam and can't insert a tampon because the pain is so severe and the fear so great.

Women with severe vaginismus will often describe the feeling as the penis "hitting a wall" when they attempt intercourse. Vaginismus can be devastating and debilitating, not because the absence of intercourse means the patient can't have a satisfying sex life, but because women with vaginismus start to think there is something crazy or abnormal about them.

Sometimes, women with vaginismus believe that if people knew the "truth" about them they would think they were aberrant. Often they find many excuses as to why they haven't dealt with the problem in the past or why they cannot begin to explore solutions now. They often begin to avoid every type of sex or sexual encounter.

View animation on vaginismus:

Part of the condition is psychological; the women suffering from this are scared, anxious, and in some cases even phobic. However, the condition also has significant physiological causes. In most cases, the muscles at the entrance to the vagina, the "introitus," are found to be in an involuntary spasm and a patients experience severe pain upon attempted entry.

So please don't believe it if anyone tells you this condition is in your head, that you "should" be able to relax or just "drink a glass of wine." Those things would not, in all likelihood, cure a severe back spasm. They are just as unlikely to be your solution to this problem as well.

Vaginismus Treatment

The goal of treatment for vaginismus is to eliminate painful sex. Treatment usually involves the use of vaginal dilators to relax and stretch or re-stretch the vaginal muscles. Additional treatment may involve increasing lubrication through topical creams, using hormone therapy or by increasing the blood flow with Viagra, as well as relaxation exercises and breathing techniques.

What is most important to understand is that the physical part of the condition it is very treatable with a range of treatment options; these treatments often result in a successful outcome in a relatively short period of time. Using dilators and a topical anesthetic along with professional coaching, most women find their condition resolved in two-to-three months.

For cases of vaginismus where a patient is unsuccessful after treatment with dilators and coaching, and in cases where a patient is extremely fearful of standard treatment, we treat vaginismus with Botox®. You can explore more about this by requesting our free information packet or calling our offices to discuss this with one of our staff. While the Botox® treatment is a more involved procedure, resolution is fast and permanent.

Happily there are a number of treatments that have proven successful. Our most urgent message is this: If you think you are suffering from vaginismus, there are solutions that will likely resolve the problem. But the first step begins with a call to a professional who can and will help.


Read Dr. Bat Sheva Marcus' article about Botox and Vaginismus.

Free women’s sexuality information packet.

Contact us for more information about the center or call us to make an appointment at (914) 328-3700.

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Sexual Dysfunction in Women

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Information provided on this website is authored and edited by Dr. Bat Sheva Marcus, LMSW, MPH, PhD
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